Dual antiplatelet therapy combined with tirofiban on emergency percutaneous coronary interventions in diabetic patients affected by acute myocardial infarction
Liu Yang
Liu Hengliang
Chen Qi
Ji Jinrui
Chen nan
Jia Kailong
Abstract：Objective To investigate the efficacy and safety of dual and triple antiplatelet therapy (DAPT and TAPT) in emergency percutaneous coronary interventions (PCIs) performed in patients with diabetes and acute ST segment elevation myocardial infarctions (D-STEMI). Methods The D-STEMI patients (n=258) were randomly divided into three groups. Group A (85 patients) was treated with aspirin and clopidogrel; group B (87 patients) received aspirin, clopidogrel, and tirofiban; and group C (86 patients) was treated with aspirin, ticagrelor, and tirofiban. Patients in all three groups received oral DAPT, and the patients in groups B and C received intravenous tirofiban when emergency PCI was performed. The basic clinical data, coronary lesion characteristics, length of hospital stay, and complication rate were compared between the three groups. Results Compared with group A, the post-PCI thrombolysis in myocardial infarction (TIMI) grade 3 blood flow and the TIMI myocardial perfusion grade (TMPG) 3 in groups B and C were significantly increased (P<0.05),and the incidence of major adverse cardiac events (MACE) was significantly decreased (P<0.05). Compared with group B, the rate of TMPG 3 in group C was significantly increased (P<0.05), and the incidence of MACE was significantly decreased (P<0.05). Patients in group B exhibited minor bleeding; however, the incidence of mild to moderate bleeding in group C was significantly increased (P<0.05). Conclusions TAPT effectively improved the TIMI blood flow and TMPG and reduced the occurrence of MACE. Ticagrelor was more effective than clopidogrel in TAPT; however, when using the combination of aspirin, ticagrelor, and tirofiban, close attention should be paid to possible bleeding complications.
Keywords：Acute myocardial infarctionDiabetesEmergency percutaneous coronary interventionAntiplateletBleeding
Publication Date：2019-01-01
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：6( 200-204,208 )